Autism spectrum disorder (ASD) has an unclear cause but is associated with various genetic, neurologic, metabolic, and immunologic factors. Although there is no definitive treatment, there has been an increased use of dietary interventions and nutritional support in these patients.

Pharmaceutical and behavioral therapies are often used, but with limited success. This can be due to the high variability of autism as well as adverse reactions to medications.

According to a new study published last Friday in the journal Nutrients, researchers investigated the role of vitamin D and omega-3 fatty acids in modulating the inflammatory state and helping to improve the core symptoms of ASD. While a few past studies have looked into this with inconclusive results, the research team hypothesized that an inflammatory state may play a role on the effect of these nutrients as well as symptoms.

This randomized, double-blinded, placebo-controlled study included 73 children ranging from two and a half to eight years of age over a 12-month period. Each child was randomly assigned to one of 4 groups: supplementation of 2000 IU of vitamin D, 722 mg of DHA, a combination of both, or placebo. Laboratory assessment included interleukin-1β (IL-1β), vitamin D 25-OH, RBC fatty acids, calcium, albumin, iron, and vitamin B12. The Social Responsiveness Scale (SRS) questionnaire was also used to assess each child’s symptoms at baseline and at the end of the study.

Elevated levels as well as genetic polymorphisms and mutations of IL-1β have been frequently reported in patients with ASD. An increased level of IL-1β can have negative neurological effects related to ASD as it can disrupt and cross the blood-brain barrier. Previous research demonstrated a positive correlation between IL-1β, impaired behavioral outcomes and regressive onset in children with ASD.

As a result, the research team found that both vitamin D and omega-3 fatty acids were significantly superior compared to the placebo in improving social and communicative functioning when baseline IL-1β concentrations were elevated. This study demonstrates the role and potential benefits in managing some symptoms of ASD in a specific subgroup of children with inflammation. This is also supports the importance of personalized treatment.

Previous research has recommended addressing deficiencies of vitamin B12, vitamin D, and essential fatty acids for their effectiveness in ASD. Folinic acid has also been shown to help improve the symptoms of ASD.

While it may be possible for children with ASD to obtain most of their required nutrients from their diet, it is essential to determine the specific nutrient needs of each child. The level of nutrient intake that maintains the best possible health is highly variable from person to person. Lifestyle choices and environmental exposures filtered through genetic predisposition are fundamental factors in ASD, and a successful treatment approach must include investigation into these factors.

It is also essential to assess gut health. Children with ASD have significantly different concentrations of certain bacteria in their stool compared to children without ASD. It is suspected that gut microbes can alter the levels of neurotransmitter-related metabolites, affecting the gut-to-brain communication and altering brain function.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Mazahery H, Conlon C, et al. Inflammation (IL-1β) Modifies the Effect of Vitamin D and Omega-3 Long Chain Polyunsaturated Fatty Acids on Core Symptoms of Autism Spectrum

Disorder—An Exploratory Pilot Study. Nutrients. 2020 February 28; 12(3),661.